RCT designed to evaluate the impact of Lactobacillus reuteri DSM17938 to modify gut microbiota in children delivered by C-section

RCT designed to evaluate the safety and efficacy of L. reuteri DSM17938 administrated to newborns babies to modify the fecal microbiome after 30 days of supplementation. Secondary Secondary endpoints will be evaluate the occurrence and frequency of AEs Day 0 to Day 60; The gut bacterial composition Day 7 and Day 30 as described in primary endpoint; the gut bacterial composition in infants born by c-section and supplemented with L. reuteri DSM17938 compared to the gut bacterial composition in infants born vaginally and the salivary concentration of IgA at 48h ±3h after birth and at Day 30.

Inclusion Criteria:

• Gestational age >37weeks +0 days and <39 weeks +0 days
• Birth weight appropriate for gestational age (AGA) or Large for Gestational Age (LGA)
• Apgar score 8 or greater
• Children will receive more than 50% of the feeding occasions with human breastmilk
• Mothers will have the intention to exclusively or predominantly breastfeed the subject. On the diary report form mother will report day by day the frequency of human lactation and the frequency and amount of infant formula.
• Readiness and the opportunity for parents to fill out a study diary, questionnaires.
• Parent(s) are willing to postpone major changes in the infant feeding mode, and
• Written informed consent from parents

Exclusion Criteria:

• Older than 24 hours after birth when given the first dose of investigational product
• Any kind of chronic or acute diseases during pregnancy that can modify fecal microbiota in children, e.g. gestational diabetes, pre-clampsia, gastrointestinal disease
• Congenital malformations or anomalies
• Maternal use of antibiotics from gestational week 33 and throughout the study period.
• Maternal use of probiotics from gestational week 33 and throughout the study period.
• Maternal severe obesity at inclusion or at delivery evaluated using Rosso Madrones centiles
• Infant use of antibiotics throughout the study period.
• Infant use of probiotics throughout the study period, including infant formula and/or supplementation.
• Infants carrying out general anesthesia
• Meconium aspiration syndrome
• History of premature disruption of membranes for >24h
• Participation in other clinical trials

Protocol documents and data base results will be available at international sites

January 2019, for 12 months

IPD sharing access will be available for all investigators who want to do secondary analysis, always giving credits to principal investigators and owner of this research

Blinding process will be structured centrally. The oil drops of active are contained in an ambar flask. Placebo consistency, smell, flavor and container are identical to active product